AFFORDABLE CARE ACT

Consumers find buying insurance can be tricky

Some glitches affect programs being used by salesmen locally

Joe Moore, a local independent insurance agent, talks with Jane York about the Affordable Care Act at Rite Aid on Sylvania Avenue in Toledo.

Hurry up and wait.

That’s the experience of some consumers in the Toledo area looking for information about the Affordable Care Act, and also by people who have been enlisted to help consumers make their way through the maze of information about the federal health-care marketplace.

Since the Oct. 1 launch, the federally run healthcare.gov Web site has been riddled with technical glitches causing crashes and error messages. According to published reports, some independent computer experts are citing the decision to force consumers to create online accounts before they browse available health plans as a major design flaw that has led to many of the problems.

Toledo resident Nancy Bourkquin tried to log into the Web site several times before she ran out of patience and opted to try to find some face-to-face help. She learned a month ago that several Rite Aid stores in town were planning to have insurance agents in the stores to provide information and help consumers enroll in a health-care plan.

Nationwide, there are nearly 2,000 Rite Aid stores slated to offer free health-care consultations to customers, including four stores in Toledo, and one store each in Holland, Maumee, Perrysburg, and Sylvania.

Joe Moore, a local independent insurance agent, has been contracted to work in the West Toledo store on Sylvania Avenue for the next six months. Mr. Moore is planning to use special software that will provide what he calls “two-minute” assessments for consumers who want quick answers about how much the health insurance will cost them.

On Tuesday, however, Ms. Bourkquin rushed to that Rite Aid store after work, only to find that Mr. Moore was also experiencing technical problems and was not ready to supply her with a price quote.

Mr. Moore was in his own holding pattern that day because the software is not ready and may not be up and running for another two weeks. Mr. Moore expressed his own frustration with the process as he and the other insurance agents working in Rite Aid stores are waiting for data to be loaded to the software from the private insurance companies that are participating in the health-care exchange program.

He was also planning to use the healthcare.gov Web site to enroll consumers in the plan of their choice after they completed his assessment. With no clear indication on when the federal Web site will be fully operational, Mr. Moore may have to work directly with each private insurance company to find ways to enroll prospective clients, he said.

Meanwhile, he is obligated to be in the store to give general information to the public, but doesn't know when he can begin enrolling uninsured residents in a health-care plan. And just as important for him, he won’t make any commissions from just providing counseling and information.

“I’m very disappointed because now I am unable to get rates to make the proper decision,” said Ms. Bourkquin. “In the United States of America, I never thought I would say as a citizen, ‘I have no clue what my government’s doing with regards to this health care because I can’t find out.’ ”

Ms. Bourkquin’s employer of 12 years, J.C. Penney, informed her about a month ago that her work hours were being cut and that she would no longer qualify for company-sponsored health insurance. She has picked up work as a substitute teacher to help pay her bills and she now works at J.C. Penney on the weekends.

Despite her efforts to be a proactive consumer, she said she has run into barriers at every turn when trying to find out the cost and her options for affordable health care. Her current insurance expires on Jan. 1.

“I’m gonna have to call a couple of private carriers and I’m not certain that they can even offer anything, and then I shall pray that the government gets their Web site up and running so that I can make a well-informed choice, “ she said. She added with a smile that the one thing she does not plan to do is get sick.

66 plans

Seven private insurance companies are offering a total of 66 individual and family plans on the marketplace in the six-county rating area that includes Lucas, Williams, Fulton, Defiance, Henry, and Wood counties.

Companies offering coverage options within that region are Anthem, Buckeye Community Health Plan, CareSource, HealthSpan, Medical Mutual of Ohio, Molina, and Paramount, according to the Ohio Department of Insurance.

The Ohio Department of Insurance has created guidelines for insurance agents to sell, solicit, or negotiate health plans through the exchange program. These agents can help consumers shop or enroll in coverage but they have to complete a training program and be certified.

The agents are allowed to recommend one plan over another, but they may have a contract with some or all of the insurance companies in the exchange and may receive a commission for enrolling customers in specific plans.

The insurance agents in the eight Toledo-area Rite Aid locations were hired by a Utah-based company, Green Cross. Green Cross is acting as middleman between the agents and several of the health insurance companies in the marketplace.

“The schedules vary depending on the store. They won’t be in the stores every day, but they will spend about 12 hours a week in each store,” said Lesley Walker, the Ohio zone leader for Green Cross insurance company.

Green Cross is providing back-end services for the agents and developed the software program that they will use in the stores to provide the two-minute assessments for those shopping for health care, said Mr. Moore.

Agents get pay

Mr. Moore will be paid for his services “like any other insurance agent signing up someone for life insurance,” he said. His commission on the sale will be paid to him by Green Cross, but he will only receive a fee if a consumer chooses a plan offered by one of the companies contracting with Green Cross.

“Part of me being here is that I believe in it. It's not just to make a profit,” said Mr. Moore. “I think it is a great thing that affordable health care is available for people now.”

There are no insurance agents inside Toledo-area Walgreen stores, but nationally the company is sponsoring its own Web site, www.walgreens.com/​healthcarereform, and phone line, 855-487-6969, where consumers can connect with independent insurance agents to obtain estimates on the cost of health plans. The Web site and phone line are independent of the federally run health care site.

By plugging in some basic information, consumers can obtain a quote on what they would have to pay for a bronze, silver, or gold-level health plan through the exchange.

For example, a single, 30-year-old woman with an annual income of $30,000 would be offered several plans ranging in price from $122.19 per month for a bronze-level plan with the help of a government subsidy, to as much as $429.58 per month for a gold-level plan, with the subsidy discount.

The federal government has provided grants to nonprofit agencies to train “navigators” to provide information about the exchanges to consumers. Unlike the private insurance agents, these navigators are prohibited from recommending specific plans.

CareNet and the Neighborhood Health Association are the two agencies that will train navigators for the Lucas, Williams, Fulton, Defiance, Henry, and Wood counties rating area.

Doni Miller, chief executive officer of the Neighborhood Health Association, said they will begin training up to 16 navigators. She estimates the "navigators" will be available to help people enroll in coverage by Nov. 1 at the nine Neighborhood Health Association sites in Toledo.

Hire staff

Jan Ruma, CareNet executive director, plans to hire six part-time navigators with grant money. “We hope to have the new staff hired in the next couple weeks,” she said.

The Health Insurance Marketplace is open for enrollment through March 31. Consumers must sign up by Dec. 15 for coverage to begin Jan. 1.

Contact Marlene Harris-Taylor at: mtaylor@theblade.com or 419-724-6091.